Date of Conferral

5-19-2025

Date of Award

May 2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Joseph Robare

Abstract

The rising prevalence of prediabetes in the United States presents a significant public health challenge, particularly due to its progression into Type 2 diabetes. Despite national dietary guidelines, disparities in dietary adherence persist, especially among food-insecure adults. This quantitative study examined the impact of food insecurity and MyPlate utilization on HbA1C levels in prediabetic U.S. adults, while accounting for structural and intermediary determinants of health. Guided by the Commission on Social Determinants of Health framework, this cross-sectional study utilized secondary data from the 2015–March 2020 National Health and Nutrition Examination Survey including a sample size of 1,417 noninstitutionalized male and female respondents over the age of 18. Multiple linear regression analyses revealed that MyPlate utilization was a significant predictor of lower HbA1C levels across models p < .001. High food security status compared to low and very low food security also significantly influenced HbA1C levels with p < .001. These findings underscore the critical role of dietary adherence and food security in glycemic control. Public health strategies should prioritize nutrition education, improved food accessibility, and targeted interventions to mitigate diabetes risk. This study advances positive social change by emphasizing the need to reduce food insecurity as a modifiable risk factor and by promoting evidence-based dietary strategies like MyPlate to improve glycemic outcomes among adults with prediabetes. These efforts may influence policies and community interventions that support nutrition education, increase access to healthy foods, and reduce health disparities in vulnerable populations.

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